CAN-SG has sent a letter to the heads of all the medical schools in the UK asking them to review their endorsement of the GLADD charter (The Association of LGBTQ+ Doctors and Dentists). The GLADD charter asks medical schools to sign up to 6 commitments against LGBTQ+ conversion practices and in support of affirmation of gender identity.
CAN-SG believes no-one should be subjected to conversion practices, but the meaning of conversion practices (or conversion therapy as it is sometimes called) in relation to gender identity is ambiguous and contested. Practitioners who provide exploratory therapies instead of immediately affirming a person with gender dysphoria or incongruence in the belief their problems are located in their body, and put them on a pathway for hormonal and surgical treatments, have been accused of conversion therapy. The concern is that a conversion practices ban for gender identity could risk criminalising ordinary exploratory therapy and medical assessment. Even if that is not the intention of the legislation, the fear of being accused of criminal acts could have a chilling effect on practitioners’ ability and willingness to work in the field of gender. This is a concern raised in the Cass Review.
The Cass Review Final Report – Cass Review is the best available evidence we have for the management of gender distress in children and young people. The Cass Review says that care must be taken not to undermine the provision of support for gender distressed children and young people.
The intent of psychological intervention is
not to change the person’s perception of who
they are but to work with them to explore their
concerns and experiences and help alleviate
their distress, regardless of whether they pursue
a medical pathway or not. It is harmful to equate
this approach to conversion therapy as it may
prevent young people from getting the emotional
support they deserve. (Cass Review p.150)
Fear of litigation is likely to adversely affect recruitment and this is already difficult as this is a challenging field. There should be ongoing open discussion about this matter in the medical profession and in medical education.
Similarly, the Cass Review does not support the model of a fixed, innate gender identity being the sole cause of gender distress with one treatment pathway of affirmation. In contrast, the Cass Review describes a model where there are multiple pathways into and out of gender distress and a treatment pathway that involves holistic and thorough medical assessment, in line with usual medical practice. We do not think the GLADD charter is in line with this due to promoting affirmation instead, and risking a “chilling effect” regarding teaching, research and clinical discussion in this important area.
Freedom of Speech in Universities
The Office for Students recently fined Sussex University £585,000 for failure to protect academic freedom and governance failures and highlighted a “chilling effect” of a Trans and Non-binary Policy Equality Statement that did not take in account freedom of speech protections or the rights of other groups:- https://www.officeforstudents.org.uk/news-blog-and-events/press-and-media/university-of-sussex-fined-585-000-for-free-speech-and-governance-breaches/
As well as reviewing internal policies to prevent similar errors and consequences, it is also important for medical schools to consider removing their signatures from the GLADD Charter, which has a very similar chilling effect and may inadvertently be causing harm.
Some medical schools and universities have a policy of not signing up to any external charter – due to reasons such as avoiding obligations which could increase bureaucracy or risk, avoiding risk of misalignment of values over time, protecting neutrality, redundancy with internal policies with better governance and review processes already in place, and protecting institutional autonomy.
Read the CAN-SG letter to all medical school signatories of the GLADD charter here which explains the risks discussed here in more detail and also includes risk of discrimination against protected belief.
We have sent this to the university Vice Chancellors and to the Dean or Head of School of the medical schools.